GHD in the Newborn Period

Hypopituitarism may present in the newborn in a nonspecific fashion. Signs and symptoms include: apnea, cyanosis, pallor, lethargy, jitteriness, and seizures. The differential diagnosis of hypogylcemia includes GHD and hypopituitarism, which could include cortisol deficiency. Prolonged hyperbilirubinemia may be owing to TRH or TSH deficiency, causing hypothyroidism in a neonate with multiple hormone deficiency. Patients with congenital hypopituitarism may have a turbulent neonatal course, generally more characteristic of a full-term infant because of the frequency of neonatal problems in preterm infants. Neonatal glucocorticoid deficiency can present as hyponatremia.

In general, newborns with congenital hypopituitarism have normal birth weights and body proportions. Micropenis, with or without hypoglycemia, may be owing to hypopi-tuitarism. GH deficiency must be considered when there are midline lesions including septo-optic dysplasia (optic nerve hypoplasia and absence of the septum pellucidum).

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